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Lot's of time, chart review, examining. Most of the job is more chart review, I have done these on a PRN basis x 2 years now. There is not way you can do one of these in any setting without taking work home. This is NOT for UC, these exams take on average 1 hour, sometimes up to 3 hours to complete. Plus you will ALWAYS take work home and/or will be reviewing test that were ordered on behave of the veteran. Most of the time the test are already set up or in process so you will get ECHOs, sleep studies, PFTs, ABIs, etc back in a few days to 2 weeks after there office visit for you to input the work into the system. I was making ~$135/hr last year after taxes. That was the average at 40% tax rate, which we only hit the 28% rate so I know I made for that $135/hr. I was a 1099 and they paid me usually $195-$220 per exam. If you are getting a "bonus" then you are most likely getting screwed unless you are making over $100/hr off this (after taxes). 

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I have experience getting one. Would not want that job. Like camoman said, lots of chart review. I had only 3 simple complaints that had already been worked up out the whazoo and it still took forever and more testing. I can’t imagine it with other veterans who have complaint lists as long as my arm, which I think is most of them.

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I have a friend who retired about 2 years ago and does this full time. He busts his ass but he made more than many docs last year...bought a porshe with cash. Another buddy is doing it part time to spend more time with the family and still grosses 6 figures.   The bonus they are giving you should be in the $100 per exam range or higher otherwise your getting screwed to be blunt.

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I looked into it a couple of years ago, based on how lucrative it looked, but after estimating the time it would take, I decided to just stick with Labor and Industries, which is actually more profitable per hour of legitimate/ethical effort in my estimation.  Plus, I like developing the relationships with long term injuries.

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22 hours ago, LT_Oneal_PAC said:

I have experience getting one. Would not want that job. Like camoman said, lots of chart review. I had only 3 simple complaints that had already been worked up out the whazoo and it still took forever and more testing. I can’t imagine it with other veterans who have complaint lists as long as my arm, which I think is most of them.

I have had some veterans with 10-12 complaints....those took hours and hours...

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I worked in Compensation & Pension at the VA for three years.  The descriptions noted above do reflect the nature of the job.  To do it right, you must review in detail sometimes decades worth of medical records, whatever is available, particularly in cases of appeals or remands.  Many veterans have multiple primary claims, and then in addition secondary claims.  General Medical exams for those just separating from service can be as many complaints as the veteran states - the most I recall was over 60 claims   You take the history, review and compile the evidence, perform an appropriate exam, order tests, and in many instances render a medical opinion on whether it is "at least as likely as not", or "less likely than not", that the claimed condition is service-related.    If you enjoy research and are very detail-oriented and have the mind of a detective this is for you.  One thing that can be discouraging, however, is the fact that  - and I have seen it many, many times - is that many veterans will lie outright or fabricate history, for the potential financial reward.  Sorry, but not all vets are honorable, and do a disservice to those who are.  Experienced examiners, however, have tricks of the trade to weed out the truth.

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Thanks for the info! The full story is it's an employer I was applying for a job with that I ended up not going through with for some other reasons. The bonus per exam was way less than the minimum that you guys are recommending and they also made it sound like there was way less involved for an exam so maybe we weren't talking about the same thing; or talking about just the exam portion or something. Who knows... 

As always, I'm super thankful for the collective experience on these forums. 

HmTwoPA: I have no idea about going about getting  those contracts, sorry. Maybe some of the others here know. 

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The least time-intensive VA exams are those termed "increase" exams, or periodic mandatory follow up of chronic claimed conditions.  These require a brief interim history, physical exam and maybe imaging.

 

HmTwoPA:  Various companies get contracted, or sub-contracted, to do these exams.  The biggest companies are QTC and LHI; they in turn farm out work to smaller companies if they can't meet the demand.

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I worked for a govt contractor (QTC) doing VA disability exams per diem for about 2.5 years.

Will echo what was said above--very painful, time consuming charting process that is impossible to do in the clinic. The exams weren't that bad; they had a protocol we were supposed to follow but I just examined them the way I would any patient and had some really interesting conversations. It is straight up shameful how the government treats some of our veterans. 

I would make between $130 and $450 per exam depending on how many complaints, whether or not an independent medical opinion was required, etc. Some days I would gross over $3k. I was a 1099.

I wouldnt want to do it as a full-time job, but for 9 months I floated my whole boat working about 1 day a week at this job. It's just unreliable work that tends to come in waves. But 100% non-clinical.

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7 hours ago, BruceBanner said:

I worked for a govt contractor (QTC) doing VA disability exams per diem for about 2.5 years.

Will echo what was said above--very painful, time consuming charting process that is impossible to do in the clinic. The exams weren't that bad; they had a protocol we were supposed to follow but I just examined them the way I would any patient and had some really interesting conversations. It is straight up shameful how the government treats some of our veterans. 

I would make between $130 and $450 per exam depending on how many complaints, whether or not an independent medical opinion was required, etc. Some days I would gross over $3k. I was a 1099.

I wouldnt want to do it as a full-time job, but for 9 months I floated my whole boat working about 1 day a week at this job. It's just unreliable work that tends to come in waves. But 100% non-clinical.

Biggest complaint my buddy had after doing this for about a year wa the depreciation of his clinical skills

Edited by ArmyPA
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  • 2 years later...

I recently had a disability exam after staying away from the VA system for 30 years or so. Some old friends I served with convinced me it was something I had earned so I waded in. I pity whoever had to do mine from the beginning. 40 years of medical records from many sources attempting to evaluate several complaints. From the time I started the process to my first determination (with 1 complaint still under review) was 14 months.

The "exams" were nothing and, I am sure following some protocol. For chronic radicular back pain the NP had me bend and extend while she measured the angle. Period.

I imagine it would be a tedious process grinding through years of paperwork and then many of your opinions would be challenged through a series of appeals.

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Yeah I hear ya Scott.  Just wondering if it's something that I can actually get paid doing lol.  I don't mind putting in the detective work, but it would have to be worth it time wise.  Also, I'm getting that 1099 vibe with them so there's that.

My big question was if the provider needed a supervising doc to do this since we are not treating, just rendering an "opinion".

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"My big question was if the provider needed a supervising doc to do this since we are not treating, just rendering an "opinion"."

Great question! I think, for what my opinion is worth, that reviewing records and giving an opinion as to degree of disability and service connection you would not. If you actually perform an exam, which may require objective evaluation and opinion, you might.

 

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I would argue that ANY professional service that you provide which requires your being licensed would require a SP.  As noted here a couple months back, even reviewing FIT questionnaires which would utilize my training and thus licensure could have been construed as practicing medicine w/o a SP.

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I work part time for the VA doing Compensation and Pension Exams. I see these contract exams all the time. Unfortunately more often then not its quantity over quality. I can not begin to describe some of the sub standard  exams that I have seen. Absolutely no quality control. It is really a embarrassment when you compare a contract exam to a VA exam.

Examples:

Service connect a 68 year old obese Veteran who had been out of the service for 48 years for degenerative arthritis of the knees. No X-rays or examination was done. Had xrays been done his bilateral knee replacements would have been found. The Veteran received a 60% rating which is 1300 a month for life

Service connect a Veteran for Diabetic Peripheral Neuropathy. The Veteran wasn't Diabetic.

Service connect a Veteran for Coronary Artery Disease without a Coronary Angiogram. He had chest pain with exertion

Service connect a Veteran 42 years post military for Cervical Degenerative Arthritis with bilateral radiculopathy. No xrays, No history of neck pain in the service. Just a newspaper article that he wrecked his car and complained of neck pain at the scene.

Service connecting a Veteran for PTSD because his drill sergeant yelled at him.

Service connecting a Veteran for PTSD because when he looked through the night vision googles he saw the enemy

Multiple instances of service connecting a veteran without reviewing any records

Doing compensation and pension examinations in a motor home parked in a motel parking lot.

Don't get me started. I have complained to the VA IG about the substandard examinations. There response is that they are apprehensive to look into these charges of fraud because it will make the VA look like they are against the Veteran.

You would be sick to your stomach if people really new what went on with contract examination scams. That's why I tell all Veterans to refuse to go to these exams and insist on going to the VA. 

This is your tax dollar that is being used to pay these fraudulent claims. Sooner or later we are going to run out of money

Edited by TDIowa
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Interesting observations and they dovetail into my experience. The problem is if you refuse to go to your examination as scheduled you may be denied for non-compliance and then have to start fighting about that.

I was sent to the same NP 4 different times for 4 totally unrelated evaluations (system wise) and got a bad exam, or no exam, each time.

I refused the 5th time because it was a specialty exam and I had already visited the VAs specialist and saw no point in seeing this NP again for an "evaluation" that would have no value compared to the one I already had. That complaint is still under review. I suspect it will get denied.

Ok we got off subject and went down a rabbit hole. Sorry OP.....

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I agree with the comments concerning the time involved and the voluminous records to search through particularly when you have a guy like me who was Vietnam Era, Agent Orange heavy exposure, wounds, and many jumps which jar the skeletal system. I waited until about fifteen years ago and it took many years to have them make decisions about things like hearing , regardless of the fact I had many encounters with explosives

 I never complained about hearing when discharged as what 21 year old does? My lung nodules were from 9/11 so that was also tossed but the Agent Orange was responsible for a plethora of problems. I think it is important to remember that you are dealing with the life and the future of many servicemen and women who placed themselves at the disposal of our civilian and military leaders and if they have a legitimate issue , we should be doing our best to help them.

Reimbursement for our services is always an important issue, after all, we are not medical missionaries but a concern for the patient is what makes us a cut above many other professions.

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Anecdotally I had to go a chiropractors office for c&p exam. It was done by an NP but the chiro was doing my x-rays(that weren't needed, I had more advanced imagining done prior to separation). I could tell he was googling how to properly position me and there multiple failed attempts for each view. The process of getting x rays done (knee and back only) took him about an hour. 

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